Duppong Hurley Kristin, Van Ryzin Mark J, Lambert Matthew, Stevens Amy L
University of Nebraska-Lincoln, 247 Barkley Memorial Center, University of Nebraska-Lincoln, Lincoln, NE 68583-0732,
Oregon Social Learning Center, 10 Shelton McMurphey Blvd. Eugene, OR, 97401,
J Emot Behav Disord. 2015 Jun 1;23(2):90-100. doi: 10.1177/1063426614541700.
To examine the link between therapeutic alliance and youth outcomes.
The study was conducted at a group-home with 112 youth with a disruptive-behavior diagnosis. Therapeutic alliance was collected routinely via youth and staff report. Outcome data were collected using youth and staff reports of externalizing behavior as well as behavioral incidents occurring during care. Outcome data were collected following intake into services and at 6 and 12 months of care. Data were analyzed to examine (1) if youth behavior problems at intake were predictive of therapeutic alliance and (2) if changes in alliance were predictive of subsequent youth outcomes. These were conducted with a 6-month service-delivery model and replicated with a 12-month model.
There was some support for the first hypothesis, that initial levels of youth externalizing behavior would be related to alliance ratings; however, most of the effects were marginally significant. The second hypothesis, that changes in therapeutic alliance would be related to subsequent youth outcomes, was supported for the 6-month model, but not the 12-month model.
Changes in therapeutic alliance may be predictive of youth outcomes during care. Additional research into examining therapeutic alliance trajectories is warranted to improve mental health services for youth.
探讨治疗联盟与青少年治疗效果之间的联系。
该研究在一个为112名患有破坏性行为障碍的青少年提供集体居住服务的机构中进行。通过青少年和工作人员的报告定期收集治疗联盟的数据。使用青少年和工作人员关于外化行为以及在照护期间发生的行为事件的报告来收集结果数据。在青少年接受服务时以及照护6个月和12个月时收集结果数据。对数据进行分析，以检验（1）青少年在接受服务时的行为问题是否可预测治疗联盟，以及（2）治疗联盟的变化是否可预测青少年随后的治疗效果。这些分析采用6个月的服务提供模式进行，并以12个月的模式进行重复验证。
第一个假设，即青少年外化行为的初始水平与治疗联盟评分相关，得到了一定程度的支持；然而，大多数影响仅具有边缘显著性。第二个假设，即治疗联盟的变化与青少年随后的治疗效果相关，在6个月的模式中得到了支持，但在12个月的模式中未得到支持。
治疗联盟的变化可能预示着青少年在照护期间的治疗效果。有必要对治疗联盟轨迹进行更多研究，以改善青少年的心理健康服务。
